Living with a urinary catheter


One of the common complications of long-term catheter use is encrustation by mineral salts, leading to catheter blockage. Crystalline deposits can form on the retention balloon, obstruct the eye holes and block the urine drainage channel. Bacterial infections make the urine alkaline, so that crystals form on the catheter surface. These obstruct the flow of urine so that the bladder steadily distends. This can become very painful. Urine retained within the bladder can either leak around or bypass the catheter causing incontinence, or it can flow back or ‘reflux’ to the kidneys, which can lead to serious kidney and bloodstream infections, pyelonephritis and septicaemia. About half of all long-term catheter users experience catheter encrustation and blockage at some time (references: Kohler-Ockmore and Feneley, 1996; Getliffe, 1994). Sudden catheter blockage can be distressing. It can occur at any time and is a common emergency for district nurses.
Some people we interviewed had rarely had a blockage. Peter Y had had none while he had good care with high standards of hygiene, but had lots of blockages when his care changed.
Having a blockage can be frightening and several people said that the first one they had was particularly so because they didn’t know what was wrong. A few also said that regular blockages can take over a person’s life. Emlyn and Sharon said they had pain whenever their catheter was blocked. Jack tried to phone the district nurse before he got any pain. Urine leaking from his penis told him that his catheter was blocked. Michelle knew when her catheter was blocked because her leg bag stopped filling up as normal.
Some people with a spinal cord injury said that their catheter blocking could be serious because it could cause autonomic dysreflexia, which can be life threatening. It occurs when the blood pressure in a person with a spinal cord injury above T5-6 becomes excessively high. The most common symptoms are sweating, pounding headache, tingling sensation on the face and neck, blotchy skin around the neck and goose bumps. Not all the symptoms always appear at once and their severity may vary.
Some people got a blocked catheter every now and then and used a bladder washout to clear it. This is done by flushing out the bladder with a sterile saline or acidic solution through the catheter into the bladder. It is contentious whether or not to use these solutions (see ‘Bladder washouts’). Ian, who’d had an indwelling catheter for over 20 years, said he had many blockages until he started using bladder washouts to try and prevent them. Michelle said that bladder washouts never worked for her – she gets headaches with them because her bladder is so small. Whenever her catheter becomes blocked, she always has to have it changed.
One of the concerns people had was that the catheter could get blocked at any time, day or night. Peter Z said his catheter invariably blocked in the middle of the night. He would have to phone his local emergency number for a district nurse to come and change it. The nurse usually came round quickly. John Z said he rarely had his catheter changed every 10 weeks as intended because it always got blocked before then.
Most people phoned a district nurse when their catheter was blocked, or a local emergency centre that contacted a district nurse who would then visit them at home. Rachel, though, said her husband lived in a residential care home. When his catheter became blocked, staff did not know what to do so they were told to bring him into hospital where the catheter was changed. A few other people recalled occasions when they’d gone to Accident and Emergency because of a blocked catheter.
A few people felt they’d discovered a way of preventing catheter blockage. Stuart, for example, said he cleaned his catheter with a pipe cleaner in order to prevent blockages. Although doctors do not recommend this, it had worked very well for Stuart, who now rarely gets blockages. Other people recommended drinking lots of fluid, especially citrus drinks, to try and prevent blockages (see ‘Drinking lots of fluids’).

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Last reviewed October 2018.


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